Individual provider Active NPI

Emily Gilchrist, PTA

  • Physical Therapy Assistant
  • Fernandina Beach, FL
National Provider Identifier
1700023413
Registry record updated Jan 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA20827 Issued in FL
Practice address
1897 Island Walk Way Ste 6
Fernandina Beach, FL 32034-1949
Phone
(904) 261-4664
Fax
(904) 261-5852
NPI assigned
Jan 16, 2009
Last updated
Jan 16, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA20827 FL Primary

Addresses

Primary practice location

1897 Island Walk Way Ste 6
Fernandina Beach, FL 32034-1949

Mailing address

PO Box 949
Rome, GA 30162-0949
Phone (706) 802-1991

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PTA20827FLMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Advance Rehabilitation and Consulting Physical Therapy Assistant Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1232064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232064000000",
    "number": "1700023413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 949",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301620949",
            "telephone_number": "706-802-1991",
            "fax_number": "706-802-1408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1897 ISLAND WALK WAY STE 6",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320341949",
            "telephone_number": "904-261-4664",
            "fax_number": "904-261-5852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILCHRIST",
        "first_name": "EMILY",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-16",
        "last_updated": "2009-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA20827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fernandina Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.